Senators Reach Deal To Pay For Veterans' Care Outside VA SystemSenators have reached a bipartisan agreement to build more clinics for veterans, hire more doctors and to allow the faster dismissals of senior level employees at the Department of Veterans Affairs.

Senators have reached a bipartisan agreement to build more clinics for veterans, hire more doctors and to allow the faster dismissals of senior level employees at the Department of Veterans Affairs.

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We will report next on the agency created to care for all of America's veterans. Eric Shinseki resigned a week ago. He was secretary of Veterans Affairs, and he stepped down amid reports of treatment delays and deceptive scheduling practices at VA medical centers. Now members of the U.S. Senate have cobbled together a bipartisan proposal to fix the problems. Their plans will provide more health facilities for veterans, allow them to visit private clinics if they wish and make it easier to dismiss poorly performing officials. NPR's Ailsa Chang reports.

AILSA CHANG, BYLINE: Over the last 24 hours, the deal came down to two men in the Senate. One a self-described democratic socialist and another former Republican presidential nominee. Listening to Bernie Sanders of Vermont and John McCain of Arizona, you would've thought hammering out an agreement was a monumental struggle.

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SENATOR BERNIE SANDERS: Reaching a compromise among people who look at the world very differently is not easy.

SENATOR JOHN MCCAIN: Bernie Sanders is known as a fighter, and it's been a pleasure to do combat with him.

(LAUGHTER)

CHANG: But for all the talk about combat, a compromise on how to address the problems within the VA's health care system came surprisingly swiftly, at least for a Senate that has managed to get little else done this election year. Democrat Chuck Schumer of New York says veterans simply represent a different priority in Congress.

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SENATOR CHUCK SCHUMER: We still have to have people who won't put extraneous amendments, killer amendments, on this bill. But it's a higher calling to help our veterans.

CHANG: That higher calling reached a fever pitch after the toppling of Secretary Eric Shinseki and a scathing Inspector General report, finding treatment delays averaging as long as 115 days. Sanders says doctors at VA hospitals are getting burned out, working 12 to 15 hour days. The turnover rate is staggering.

(SOUNDBITE OF ARCHIVED RECORDING)

SANDERS: There are areas of the country where we simply do not have the doctors, the nurses and the other staff that we need to provide the care that our veterans deserve.

CHANG: So under the proposal, over the next two years, the VA will pay veterans to see private doctors if they choose. But that only applies to vets who live at least 40 miles away from a VA facility or to those facing unreasonable treatment delays. It's a provision McCain has long favored, but he notes nothing can actually replace the specialized care the VA provides.

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MCCAIN: There are things done in the veterans' health care system that only the veterans' health care system can handle - PTSD, traumatic brain injury, spinal cord injury, prosthesis, war wounds - that only the VA can do.

CHANG: But after the announcement, Sanders said increasing access to private doctors was one of the toughest concessions he had to make in the deal.

(SOUNDBITE OF ARCHIVED RECORDING)

SANDERS: You know, it opens up a fear of privatization, which I strongly, strongly am opposed to. I think the VA is a strong system. I think we need to make it a stronger and better system.

CHANG: And to make it stronger and better, the proposal would also let the department lease 26 new medical facilities in 18 states to absorb some of the patient backlog. And $500 million would be set aside to hire more doctors and nurses. But some senators contend additional staff is the last thing the VA needs. Republican Tom Coburn of Oklahoma says doctors within the system just have to learn to be more efficient.

(SOUNDBITE OF ARCHIVED RECORDING)

SENATOR TOM COBURN: Primary care appointments, they work at half the rate of which doctors outside the VA work.

CHANG: Coburn says VA doctors need to see as many patients as other doctors do.

COBURN: Money is not the problem at the Veterans Administration. It's management and accountability.

CHANG: To increase accountability, the proposal lets Veterans Affairs secretary immediately fire officials based on poor performance. But it provides an appeals process to the fired employee. Senate leaders say they hope to get the legislation to the floor very soon. Ailsa Chang, NPR News, the Capitol.

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